What Is Hormone Therapy A Look At The 5 Most Common Types
Hormone replacement therapy is a commonly used phrase that applies to many different types of treatment. Before we look at the 5 most common types of hormone therapy, let us examine why it is important.
HRT is used in the following ways:
- To reverse the symptoms of menopause in women
- To counteract the effects of Low T or andropause in men
- To raise growth hormone levels when the pituitary gland no longer secretes enough GH
- As a treatment for some types of breast cancer
- To block the growth of prostate cancer cells
- To improve heart, brain, and internal organ functions
- To support the bodys well-being by balancing hormone levels
What is hormone therapy and how is it used?
Hormones are the chemical messengers of the body that come from various places in the endocrine system, including the adrenal, pituitary, and thyroid glands, as well as the pancreas and even the liver. As hormones travel through the bloodstream, they search out their particular receptor cells and deliver their signals that put into action their various effects. Hormones regulate the functions of the bodys different cells.
Hormone therapy is used to either enhance or block a hormones functions. If the purpose is to block a function with hormone therapy, what is it going to do to the corresponding bodily function?
How Much Hormone Therapy Costs
The cost of hormone therapy depends on:
- the types of hormone therapy you receive
- how long and how often you receive hormone therapy
- the part of the country where you live
Talk with your health insurance company about what services it will pay for. Most insurance plans pay for hormone therapy for their members. To learn more, talk with the business office where you go for treatment. You can also go to the National Cancer Institute database, Organizations that Offer Support Services and search “financial assistance.” Or call toll-free 1-800-4-CANCER to ask for help.
Forms Of Hormone Therapy
HT comes in different forms. You may need to try different types before finding one that works best for you.
Estrogen comes in:
- Vaginal suppositories
- Intrauterine device or intrauterine system
The type of HT your doctor prescribes may depend on what menopause symptoms you have. For example, pills or patches can treat night sweats. Vaginal rings, creams, or tablets help relieve vaginal dryness.
Discuss the benefits and risks of HT with your provider.
What Is Hormone Therapy
Hormone therapy is a type of cancer treatment used to slow or stop the growth of cancers that need hormones to grow.
What Is Hormone Therapy Used For?
Hormone therapy is commonly used to treat some breast, prostate, and endometrial cancers that use hormones to grow.
Hormone therapy is used to:
- Treat cancer by slowing its growth or lessening the chance it will return
- Ease cancer symptoms in men with prostate cancer who are not able to have surgery or radiation therapy
- Hormone therapy is often used with other cancer treatments to:
- Shrink a tumor before surgery or radiation therapy
- Lower the risk that cancer will recur after the main treatment
- Kill cancer cells that have returned or spread to other parts of the body
Treatment To Lower Androgen Levels From The Adrenal Glands
LHRH agonists and antagonists can stop the testicles from making androgens, but cells in other parts of the body, such as the adrenal glands, and prostate cancer cells themselves, can still make male hormones, which can fuel cancer growth. Drugs are available that block the formation of androgens made by these cells.
Abiraterone blocks an enzyme called CYP17, which helps stop these cells from making androgens.
Abiraterone can be used in men with advanced prostate cancer that is either:
- High risk
This drug is taken as pills every day. It doesnt stop the testicles from making testosterone, so men who havent had an orchiectomy need to continue treatment with an LHRH agonist or antagonist. Because abiraterone also lowers the level of some other hormones in the body, prednisone needs to be taken during treatment as well to avoid certain side effects.
Ketoconazole , first used for treating fungal infections, also blocks production of androgens made in the adrenal glands, much like abiraterone. It’s most often used to treat men just diagnosed with advanced prostate cancer who have a lot of cancer in the body, as it offers a quick way to lower testosterone levels. It can also be tried if other forms of hormone therapy are no longer working.
Ketoconazole also can block the production of cortisol, an important steroid hormone in the body, so men treated with this drug often need to take a corticosteroid .
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What Is Known About Hormone Therapy And The Risk Of Breast Cancer
Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:
- Taking combination hormone therapy showed a rare increase of absolute risk of less than one additional case of breast cancer per 1000 person years of use.
- There was a nonsignificant reduction in breast cancer seen in women with hysterectomies on estrogen only therapy.
- If youve been diagnosed with breast cancer you should not take systemic hormone therapy.
Strengths And Weaknesses Of Study
The main strengths of this study were a very large sample representative of the general population and a study design that captured all known cases and used the richness of the data and precision of recording for prescribed drugs. The size of the sample allowed us to investigate the risks for specific treatment types and the effects of durations of exposure. We were also able to explore risks for specific subgroups of women and the effects of age at start of the therapy. The similarity of the results obtained from two databases containing data collected using different software and the results from our various sensitivity analyses have also shown the robustness of our findings.
Although levels of completeness within the databases are quite high for diagnoses, onset and symptoms of menopause are not consistently recorded. Even in the groups of women with oestrogen-progestogen prescriptions, only 48% of women had records of menopausal symptoms compared with an expected 80%. Because some symptoms of menopause are similar to symptoms of developing dementia, women without menopausal symptoms may have different underlying risk associations for development of dementia. In our sample, most of them fall within the category of non-users . Comparing women with and without symptoms may, therefore, shift odds ratios away from unity, but our adjustment for records of menopausal symptoms will have reduced that shift.
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Meaning Of Study: Explanations And Implications
Biological studies have suggested possible neuroprotective effects of oestrogen on the brain. For long term exposure in women younger than 80 at the time of diagnosis , and to a lesser extent in the subgroup analysis relating to Alzheimers disease , the results from our main analysis also supported possible protective effects for oestrogen-only therapies. For women 80 years or older at the time of diagnosis, we found no such associations, probably because of the prevailing low rates of prescription at the time of their menopause and, perhaps, also because of a decrease in the number of oestrogen receptors with age. Also according to biological studies, progestogen administered with oestrogen may result in the opposite of a protective effect because it can counteract the effects of the oestrogen. This would be consistent with our findings, which show an increase in risk of developing Alzheimers disease risk for long term oestrogen-progestogen usage, particularly among younger women .
What Types Of Cancer Is Hormonal Therapy Used For
- Breast cancer: An estimated 80% of breast cancers are hormone-sensitive , which means they are fueled by hormones. More specifically, these are called estrogen-receptor-positive or progesterone-receptor-positive breast cancers. These terms mean this particular cancer has estrogen and/or progesterone receptors, which invite hormones to bind to them. Hormone-receptor-negative cancers are not influenced by hormones.
- Prostate cancer: Most prostate cancers are stimulated by male sex hormones called androgens, says Dr. Leapman this is why urologists also refer to this treatment as androgen deprivation therapy. These hormones are made in the adrenal glands and testicles. Hormonal therapy for prostate cancer is used in several ways, including as short-term therapy for men prior to and during radiation therapy, as well as for men with advanced or metastatic cancer.
Hormonal therapy is sometimes used to destroy hormone-sensitive cancer cells that have spread to other parts of the body or those that have returned .
Hormonal therapy can also be used to ease a cancer patients symptoms . This is especially helpful for patients who are not able to have surgery or radiotherapy because of other health concerns.
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How Is Hormone Therapy Given
Hormone therapy is most often used to treat breast and prostate cancers, where its role is well established through numerous clinical trials. Meanwhile, research is ongoing to study the potential use of hormonal therapy in treating other cancer types. Hormone therapy can be given in a few ways:
- Oral medication some therapies are taken by mouth.
- Injection some therapies are given by an injection under the skin or in the muscle .
- Surgical intervention for example, removal of the ovaries in women, or testicles in men, results in decreased production of certain hormones.
Many patients think of hormone therapy as being “less potent” than chemotherapy, but it can be just as effective in certain breast and prostate cancers. Hormone therapy is considered a “systemic” therapy, meaning that it travels throughout the body. Surgery and radiation therapy are considered “local” treatments.
How Hormone Therapy Works
Some cancers use hormones to grow or develop. This means the cancer is hormone sensitive or hormone dependent.
Hormone therapy for cancer uses medicines to block or lower the amount of hormones in the body to stop or slow down the growth of cancer.
Hormone therapy stops hormones being made or prevents hormones from making cancer cells grow and divide. It does not work for all cancers.
Cancers that can be hormone sensitive include:
- breast cancer
- womb cancer
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If Cancer Has Come Back Or Spread
Hormone therapy can be used to treat breast cancer that has come back or that has spread to another part of the body .
Its given either alone or with other treatments, depending on what treatments you had before.
If your breast cancer came back during or after treatment with hormone therapy, you may be offered a different type of hormone therapy.
Types Of Hormone Replacement Therapy
There are a number of ways of providing HRT, with different levels of replacement hormones and different methods of administering them. Tablets or patches that adhere to the skin may be used to deliver the hormones used in HRT. HRT usually consists of supplementation of two hormones oestrogen and progesterone. This is because there is evidence that when women take oestrogen alone, they are at risk of womb cancer. By adding progesterone, this risk is reduced. Sometimes oestrogen-only therapy is prescribed, but this is usually only if a woman has had a hysterectomy , as progesterone is not needed in these cases. For the majority of women using hormone replacement therapy, a combination of oestrogen and progesterone is used. This is known as Combined Hormone Replacement therapy .
Types of Combined HRT include:
This is often recommended for women who are experiencing menopausal symptoms but who are still having regular or irregular menstrual periods. Cyclical HRT is taken on a monthly or three-monthly basis, allowing for breaks during which the woman will have a period. This is useful because it allows the woman and her health care provider to monitor the periods, so that it is clear when they stop. This is an indication that the woman has moved past the menopausal stage and is considered to be post-menopause.
For more specific information on the types of HRT available and what they are called, seehere.
Risk and Benefits
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What Are Common Hormone Problems
Both male and female bodies make the same hormones but at different levels. For example, women produce more estrogen while men produce more testosterone. Ultimately, this means that hormonal imbalances cause different issues for each sex. Hormone therapy can be customized to meet each persons unique chemical makeup to correct imbalances. That said, hormone imbalances can create a few common issues for everyone, depending on which hormones are unbalanced.
Most people consider testosterone to be a male-only hormone, but women need testosterone to keep the body in balance, as well. In either sex, low testosterone can cause low libido or a diminished sex drive. Low testosterone can also cause feelings of depression and lack of motivation. In men, these symptoms can also include erectile dysfunction and general lethargy.
Progesterone is produced by both men and women, but women especially require this hormone to regulate menstrual cycles and mood, particularly during pregnancy. Progesterone also helps people get restful sleep and stabilize moods. In women, low progesterone is most keenly felt during perimenopause, which is when women start to experience hot flashes, mood swings, and sleep issues.
What Are The Types Of Hormone Therapy
There are two main types of hormone therapy :
- Estrogen Therapy: Estrogen is taken alone. Doctors most often prescribe a low dose of estrogen to be taken as a pill or patch every day. Estrogen may also be prescribed as a cream, vaginal ring, gel or spray. You should take the lowest dose of estrogen needed to relieve menopause symptoms and/or to prevent osteoporosis.
- Estrogen Progesterone/Progestin Hormone Therapy : Also called combination therapy, this form of HT combines doses of estrogen and progesterone .
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How Are Hormone Therapy Medicines Used
Hormone therapy medicines may be used alone, with another type of hormone therapy, or with another type of prostate cancer treatment.
Monotherapy is when only one type of hormone therapy medicine is used to lower the amount of testosterone in your body. Monotherapy can be effective in shrinking a prostate cancer tumor, slowing the spread of your prostate cancer, and relieving pain caused by your prostate cancer. Monotherapy may be used with neoadjuvant therapy or adjuvant therapy. Please read When is Hormone Therapy Used for Prostate Cancer? to learn more about neoadjuvant and adjuvant therapy.
What Are Signs That You May Need Treatment
While all symptoms of hormonal imbalances are, to some degree, expected and necessary to cope with, the severity of these symptoms may mean its time to seek treatment. The natural decrease in hormone production in men and women can cause great enough disruption to mood, behavior, and wellness that seeking hormone therapy may be the best idea to maintain your overall health.
In terms of severity, everyone has a different level of disruption that they are comfortable to cope with. In the past, people were told to simply embrace these changes as part of the natural aging process, but these days, if you are experiencing symptoms that are truly creating a negative impact on your life, there is an effective treatment. Some of these signs include:
- Low sex drive
- Vaginal dryness or pain during sex
- Night sweats
- Weight gain of more than 10lbs
- Inability to lose weight
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What Are Male Sex Hormones
Androgens are required for normal growth and function of the prostate, a gland in the male reproductive system that helps make semen. Androgens are also necessary for prostate cancers to grow. Androgens promote the growth of both normal and cancerous prostate cells by binding to and activating the androgen receptor, a protein that is expressed in prostate cells . Once activated, the androgen receptor stimulates the expression of specific genes that cause prostate cells to grow .
Almost all testosterone is produced in the testicles a small amount is produced by the adrenal glands. Although prostate cells do not normally make testosterone, some prostate cancer cells acquire the ability to do so .
Is Hormone Therapy Right For You
Although age-related hormones are natural and expected, it doesnt mean that you have to live with symptoms, particularly if they are getting in the way of leading a healthy lifestyle. Hormones are a vital component of balancing your overall bodily function, so it makes sense to want to rebalance your hormones to reduce the severity of certain symptoms. So, do you need this type of hormone treatment?
In general, a blood serum test and a thorough consultation will be used to determine if your hormones are unbalanced enough to require correction. We will pay particular attention to any symptoms you may be experiencing and other general health factors, such as medications that could be interfering with your normal hormone production.
Hormone Therapy For Prostate Cancer
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Hormone therapy is also called androgen suppression therapy. The goal is to reduce levels of male hormones, called androgens, in the body, or to stop them from fueling prostate cancer cells.
Androgens stimulate prostate cancer cells to grow. The main androgens in the body are testosterone and dihydrotestosterone . Most androgen is made by the testicles, but the adrenal glands as well as the prostate cancer itself, can also make a fair amount. Lowering androgen levels or stopping them from getting into prostate cancer cells often makes prostate cancers shrink or grow more slowly for a time. But hormone therapy alone does not cure prostate cancer.